For the last 60 years, the UK has gloried in a healthcare system that is free to all its citizens and regularly described by politicians as the envy of the world. It has brought in a smoking ban in public places, it has good immunisation systems, cancer screening and has reduced salt in food. And yet, say the authors of a major piece of work on the global burden of disease, the UK lags behind many other comparable countries in terms of the health of its population.

The report published in the Lancet medical journal by the Institute for Health Metrics and Evaluation (IHME) in Seattle, using data supplied by UK experts and organisations, compares health in the UK with health in 18 other countries – 14 other members of the EU, plus Australia, Canada, Norway and the US.

The exercise is the first time data from the Global Burden of Disease project – which has pulled together an extraordinary amount of information from 187 countries – has been used to compare similar nations and figure out why some do better than others.

The UK is below average in terms of healthy life expectancy – the years we can expect to live before disease and disability take their toll. Not all of this is down to hospital care, by any means. In spite of the taxes on cigarettes and the smoking ban in public places, too many people still have a tobacco habit and those who have never managed to quit are prime candidates for some of the leading killers in the UK as they get older, such as ischaemic heart disease (where the blood is restricted to the heart by furring of the arteries), stroke and lung diseases.

Diet is a major issue too. Britons may eat less salt but salt consumption is still too high and we consume too much saturated fat, trans-fats and sugar. Obesity is a risk for heart disease, stroke and cancer.

The British also drink far too much, and the evidence in the report is alarming. Cirrhosis of the liver as a cause of death rose by 65% between 1990 and 2010 (it can be caused by alcohol and obesity). It is now ninth in the list of major killers. Drug use disorders are up by 577% from 64th to 21st leading cause of death. Take out people aged under 20 and over 54 and drugs and drink become highly significant – the sixth and 18th leading causes of death.

"We have a real problem with alcohol because it is getting a lot worse and we need to completely rethink our approach," said Prof John Newton, chief knowledge officer at Public Health England, who was one of the authors of the report.

The report is not supposed to be a self-flagellation exercise. Prof Chris Murray, who heads the IHME and is lead author of the paper, says the risk analysis "suggests there are large opportunities to pull the UK out from the bottom of Europe by addressing some of the risks that we outline in the paper".

Some of this is about better public health messages concerning the British diet and lifestyles, but some of it is also about the NHS.

High blood pressure can be caused by too much salt and obesity, but it can be detected by the GP and effectively brought down with cheap and simple drug treatment. Higher numbers of breast cancer deaths are to do with prevention and treatment.

There is a lot of work going on, led by the national cancer director Sir Mike Richards, to try to work out why the UK does worse than some countries. It could be to do with women going to see the GP at a late stage in the disease but it is also possible that doctors sometimes miss cancers or that optimal treatment is not offered everywhere in the UK.

The report and the data behind it, which are going to be continuously updated by the IHME, are intended to give governments the evidence they need to make changes that improve the health of their people.

• This article was amended on 7 March 2013. The original referred to "the 14 other original members of the EU" (apart from the UK) in the Lancet-published study. The study itself referred to "the original 15 members of the European Union", by which it meant the 12 members of the EU when it was established in 1993 plus Austria, Finland and Sweden, which joined in 1995.